International Journal of Psycho-Analysis 80 (1999): 929-942

“Cure With A Defect”: A Previously Unpublished Letter by Freud Concerning ‘Anna O.’1

John Forrester and Laura Cameron

Abstract

The paper makes available the text of a previously unpublished letter by Freud, probably

addressed to the founder of British ecology and former patient, Sir Arthur Tansley, F.R.S., dating

from 1932, concerning the treatment and later life of 'Anna O.', the first patient of

psychoanalysis. It gives the full text of Freud’s letter as discovered, and offers a brief

commentary on its significance as evidence of Freud’s view or views of Anna O.’s treatment,

case-history and later life. The authors compare the view of Anna O.'s treatment and later life

with other sources, in particular Freud's roughly contemporaneous letter to Stefan Zweig. The

letter's principal novel formulation is to be found in the phrase 'cure with a defect' with which

Freud characterised Anna O.'s experience of her treatment with Breuer.

***

The following letter was recently discovered amongst the papers of Sir Arthur Tansley,

F.R.S. (1871-1955), in the Library of the Department of Plant Sciences in the University of

Cambridge. On the face of it, it appears to be by Sigmund Freud, although it is written in the

characteristic hand-writing of Tansley. Assuming the letter is by Freud, it forms a noteworthy

addition to the accounts that Freud gave of the case of Anna O., the case that opened the book he
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co-authored with Josef Breuer, Studies on Hysteria (1895). The purpose of this short

communication is to give the full text of Freud’s letter and offer a brief commentary on its

significance as evidence of Freud’s view or views of Anna O.’s treatment, case-history and later

life.2 However, some basic information about Tansley may prove useful to readers.

Tansley, an English botanist with deep interests in psychology and philosophy, was for

50 years a founder of British ecology and a world leader in conservation. He worked at

University College London till 1906, when he was appointed Lecturer in Botany at Cambridge, a

post he resigned in 1923. Following his growing interest in psychoanalysis during the First

World War, he published a bestseller, The New Psychology and its Relation to Life, in 1920. For

three months in 1922, and again for six months in 1924, he was in analysis with Freud; he

became a full member of the British Psycho-analytical Society in 1925, and remained a member

till his death in 1955. In 1927, he was elected Fellow of Magdalen College and Sherardian

Professor of Botany in the University of Oxford, retiring in 1937. He played a guiding role in

government post-war nature conservation planning which began in 1941 and led to the

foundation in 1949 of the Nature Conservancy, of which he was the first Chairman, holding the

post until 1953. He was knighted in 1950.

TEXT OF THE LETTER

At the top of the single manuscript page on which the letter is copied out is the following

heading: “Letter from Freud on Breuer’s “Anna O.” 20 Nov. 1932.”

The full text of the transcription of Freud’s letter which follows this heading reads as follows:
 3

Meine Vermutungen über den Hergang bei Breuer’s erster Patientin sind sicherlich

richtig. Er hat sie gegen seine Tochter, die ihn nach der Lektüre meiner Darstellung

befragte, voll bestätigt.

Auch ist der Verlauf des Falles nicht rätselhaft. In Breuers Kranken[ge]schichte findet

sich ein kurzer Satz: - “brauchte aber doch noch längere Zeit bis sie ganz ihr

psychisches Gleichgewicht gefunden hatte.” (Studien über Hysterie, p. 32). Dahinter

verbirgt sich die Tatsache, dass sie nach Breuers Flucht neuerdings in Psychose verfiel,

und ziemlich lange - ich glaube 3/4 Jahr - in einer Anstalt fern von Wien verbringen

musste. Dann war die Erkrankung abgelaufen, aber es war eine Heilung mit Defekt. Sie

hat heute über 70 Jahre, nie geheiratet, und nach Breuers Ausspruch, an den ich mich

gut erinnere, nie eine Liebesbeziehung gehabt. Unter der Bedingung des Verzichts auf

die ganze Liebesfunktion durfte sie gesund bleiben. Breuers Behandlung hatte ihr,

sozusagen, über die Trauer hinweggeholfen. Es ist interessant, dass sie, so lange sie tätig

war, ihr Hauptinteresse an die Bekämpfung des Mädchenhandels gewendet hat.”3

In English translation4:

“My guesses about what happened afterwards with Breuer’s first patient are certainly

correct. He confirmed [them] in full to his daughter, who, on reading my

Autobiographical Study, had questioned him about them.

 4

In addition the course of the case is not enigmatic. In Breuer’s case-history, you will find

a short sentence: - “but it was a considerable time before she regained her mental balance

entirely.” (Studien über Hysterie, p. 32).5 Behind this is concealed the fact that, after

Breuer’s flight, she once again fell back into psychosis, and for a longish time - I think it

was 3/4 of a year - had to be put in an institution some way from Vienna. Subsequently

the disease had run its course, but it was a cure with a defect. Today she is over 70, has

never married, and, as Breuer said, which I remember well, has not had any sexual

relations. On condition of the renunciation of the entire sexual function she was able to

remain healthy. Breuer’s treatment, so to speak, helped her over her mourning. It is of

interest that, as long as she was active, she devoted herself to her principal concern, the

struggle against white slavery.”

SOME INTERPRETATIVE REMARKS

This letter is of interest for two principal reasons:

Firstly, it relates to Breuer’s “famous first patient” (Freud (1914) 11-12) as Freud called her in

On the History of the Psycho-analytic Movement. As is clear from Freud’s own repeated use of

the case history of Anna O. in his expositions of psychoanalysis, the story of this famous first

patient not only has great historical interest, but is useful and still debated over as a source of

understanding of psychoanalysis itself. As Freud put it, Breuer “found a technique for bringing

to her consciousness the unconscious processes which contained the sense of her symptoms, and
 5

the symptoms disappeared.... This discovery of Breuer's is still the foundation of psycho-analytic

therapy.” (Freud (1916-17) 279-80)

Secondly, Freud placed much emphasis on the fact that, behind Breuer’s published case-history,

there was a hidden story to which only he was privy, through his discussions with Breuer and

through his reconstructions of the events that went on in the early 1880s. Again, this hidden story

had more than a strictly personal or historical interest, since Freud argued that Breuer had

accidentally discovered the fundamental phenomenon that, for Freud, was the foundation for the

entire sexual theory of the neuroses: “The fact of the emergence of the transference in its crudely

sexual form, whether affectionate or hostile, in every treatment of a neurosis, although this is

neither desired nor induced by either doctor or patient, has always seemed to me the most

irrefragable proof that the source of the driving forces of neurosis lies in sexual life.” (Freud

(1914) 11-12) In 1914, Freud argued that:

In his treatment of her case, Breuer was able to make use of a very intense suggestive

rapport with the patient, which may serve us as a complete prototype of what we call

`transference' to-day. Now I have strong reasons for suspecting that after all her

symptoms had been relieved Breuer must have discovered from further indications the

sexual motivation of this transference (Freud (1914) 11-12)

Thus, any accounts of Freud’s which give further information about the treatment of Anna O.

and the sources of his information regarding this treatment will help us reconstruct how Freud

came to a different view of the case of Anna O. than the one Breuer placed on record in 1895 -

“The element of sexuality was astonishingly undeveloped in her. The patient, whose life became

known to me to an extent which one person's life is seldom known to another, had never been in
 6

love.” (Breuer and Freud (1895) 21-2) Freud himself as he grew older seemed to make of the

‘reading’ of the case history of Anna O. a potential experimentum crucis regarding the

correctness of psychoanalytic theory. The interpretation of the case not only confirmed the later

importance he accorded to the aetiology of sexuality in the neuroses, but was also an index of the

rationality of the steps by which he moved steadily away from something close to Breuer’s

position to his own mature view. His challenge to the reader in a number of publications appears

to be: If indeed one could prove that Anna O.’s neurosis was entirely without the sexual

elements that have come to be associated with psycho-analytic treatment and explanation, then

this would be a severe setback for his theory:

It will be remembered that Breuer said of his famous first patient that the element of

sexuality was astonishingly undeveloped in her and had contributed nothing to the very

rich clinical picture of the case. I have always wondered why the critics did not more

often cite this assertion of Breuer's as an argument against my contention of a sexual

aetiology in the neuroses, and even to-day I do not know whether I ought to regard this as

evidence of tact or of carelessness on their part. (Freud (1914) 11)

Freud’s letter to Tansley concerning Anna O. is one of a small number of documents that

date from the 1920s and 1930s relating to the case. Most of Freud’s accounts of the case of Anna

O. were published as part of general presentations of psychoanalysis to a wider public. His first

account of the case was as part of the Five Lectures delivered in Worcester, Massachusetts in

1909 to a general American audience. (Freud (1910) 14) In his Introductory Lectures of 1916-

17, he mentioned the case of Anna O. at certain key points in his exposition of the sense of

symptoms and the relation of psychoanalysis to hypnotism. (Freud (1916-17) 257-8, 279, 292) In
 7

three general short accounts of psychoanalysis written in the early 1920s, Freud made what had

become by then a canonical reference to Breuer’s first patient as the starting point of

psychoanalysis. (Freud (1923 [1922]) 235, 237; Freud (1924 [1923]) 193-4, 197; Freud (1926)

263-4)

The lengthiest accounts of the case of Anna O. in Freud’s published writings, however,

are to be found in those curiously hybrid - and, in relation to Breuer, curiously vacillating (see

Strachey in Breuer and Freud (1895) xxvi-xxviii) - autobiographical-historical works, On the

History of the Psycho-Analytic Movement (1914) and An Autobiographical Study (1925). These

documents - expository, historical, autobiographical - have set the precedent that has been

followed ever since: questions concerning the ‘true’ history of Anna O.’s treatment by Breuer

have become pressing for each of those who wish to give a historical account of the development

of analysis, a wish that simultaneously expresses itself as an inquiry into the early development

of Freud’s own thinking in the 1880s and after.

Thus, in October 1928, when Ernest Jones was asked to give a biographical account of

Freud - premonitions of things to come! -, the very first question of fact he put to Freud

concerned Anna O., as if Freud’s awareness of her case marked his birth as ‘Freud’:

I have been asked to write a Biography of you for the Encyclopaedia Britannica. If there

is time I will send you a copy to correct, but feel I should be competent for even this

responsible task. I wonder if you can remember when it was that Breuer first told you of

Anna O.? I assume it must be about 1884. (Freud/Jones (1993) 20 October 1928, 650)

Freud’s reply was direct but failed to answer precisely the question Jones had specifically asked

him:
 8

You are right in assuming that Breuer's reports of his case date from about 1884. Our

relationship began gradually about 1882, in 1885 I went to Paris. (Freud/Jones (1993) 27

October 1928, 652)

Around the same time (probably in 1927), Marie Bonaparte made notes about conversations she

had during her analysis with Freud about the famous first patient of Breuer’s.(Borch-Jacobsen

(1996) 30, 93-103) Five years later, Stefan Zweig’s quasi-biographical study of Freud, Mental

Healers of 1932, elicited the frankest and most detailed account, prompted by what Freud

regarded as an “error of representation” in Zweig’s book concerning Anna O.’s treatment:

It [your book] declares that Breuer's patient under hypnosis made the confession of

having experienced and suppressed certain “sentimenti illeciti” (i.e. of a sexual nature)

while sitting at her father's sickbed. In reality she said nothing of the kind; rather she

indicated that she was trying to conceal from her father her agitated condition, above all

her tender concern. If things had been as your text maintains, then everything else would

have taken a different turn. I would not have been surprised by the discovery of sexual

etiology, Breuer would have found it more difficult to refute this theory, and if hypnosis

could obtain such candid confessions, I probably would never have abandoned it.

What really happened with Breuer's patient I was able to guess later on, long after the

break in our relations, when I suddenly remembered something Breuer had once told me

in another context before we had begun to collaborate and which he never repeated. On

the evening of the day when all her symptoms had been disposed of, he was summoned

to the patient again, found her confused and writhing in abdominal cramps. Asked what

what was wrong with her, she replied: “Now Dr. B.'s child is coming!”
 9

At this moment he held in his hand the key that would have opened the “doors to the

Mothers”, but he let it drop. With all his great intellectual gifts there was nothing

Faustian in his nature. Seized by conventional horror he took flight and abandoned the

patient to a colleague. For months afterwards she struggled to regain her health in a

sanatorium.

I was so convinced of this reconstruction of mine that I published it somewhere. Breuer's

youngest daughter (born shortly after the above-mentioned treatment, not without

significance for the deeper connections!) read my account and asked her father about it

(shortly before his death). He confirmed my version, and she informed me about it later.

(Freud (1960), Freud to Stefan Zweig, 2 June 1932, 408-9)

When Ernest Jones published the first volume of his biography of Freud in 1953, he gave

an account of Breuer’s treatment of Anna O. which made public for the first time the fact that

Breuer’s case history was at best partial and at worst highly misleading as to the subsequent fate

of his patient and her medical treatment. He in part based himself on stories told him directly by

Freud, and in part on the evidence of letters exchanged between Freud and his then fiancée

Martha Bernays, from 1882 on. Some of these letters have subsequently been made partially

available. (Forrester (1986), Forrester (1990), Appignanesi and Forrester (1992) 81-2) Following

Jones’ account, pioneering research by Henri Ellenberger (1972) and Albrecht Hirschmüller

(1978/1989) has revealed the extent to which Anna O. - Bertha Pappenheim - suffered a severe

and prolonged relapse following the end of her treatment by Breuer. Subsequent research into

her case and into the various accounts given by Breuer, Freud and others is conveniently

summarised in Remembering Anna O. A Century of Mystification, a book-length study published

in 1996 by Mikkel Borch-Jacobsen, which demonstrates to sceptics how painstaking accuracy

 10

can be perfectly combined with remarkably sustained tendentiousness. We do not intend to enter

into these controversies here, but this previously unpublished letter does call for some

commentary concerning certain new elements concerning Freud’s view of the case. It should be

borne in mind that the letter was written only five months after Freud had written, off his own

bat, to Stefan Zweig about Breuer’s treatment of Anna O.

The first sentence of the letter is probably a response to Tansley’s query concerning the

reliability of the account Freud had given in On the History of the Psychoanalytic Movement

and An Autobiographical Study. In his letter to Zweig, Freud had referred to having been “so

convinced of this reconstruction of mine that I published it somewhere” - leaving it unclear what

publication he was referring to. This letter to Tansley confirms that the passage Dora Breuer read

was in An Autobiographical Study, published in February 1925, and she must have asked her

father about it before his death on 20 June 1925.6 What exactly Dora Breuer asked her father,

and what exactly he confirmed must remain a matter of speculation, as both Fichtner (1989, 75)

and Borch-Jacobsen (1996, 37-8) agree. In contrast to the letter Freud wrote Zweig, to Tansley

he gives no further details whatsoever of the “untoward event” (Freud (1914) 12; English in the

original) which abruptly terminated Anna O.’s treatment, beyond informing him that Breuer had

indirectly confirmed the account Freud had already published.

The next paragraph of the letter is framed in a way that at first reading might be called

more ‘conciliatory’ in relation to Breuer’s published account than his remarks to Zweig and his

reported comments to Bonaparte.7 Freud emphasizes the ‘considerable time’ that Breuer had

admitted elapsed before she regained her health. In the Zweig letter, he mentions “for months

afterwards”; in the letter to Tansley he speaks of “a longish time - I think it was 3/4 of a year -

had to be put in an institution some way from Vienna”. Following the most accurate modern
 11

reconstruction of Anna O.’s treatment, that of Albrecht Hirschmüller, we see that Bertha

Pappenheim spent four months from July to October 1882 being treated at Kreuzlingen and then

two further periods at the asylum at Inzersdorf, one of five and a half months, the second of four

months, in 1883-85, and a further 18-day stay in July 1887. (Hirschmüller (1978/1989), 279-301)

We thus see that Freud’s recollection of these events from fifty years previously was not far off,

although he may well have been omitting from his calculation the second and third stays at

Inzersdorf. It should be noted, however, that this is the only extant source in which Freud

specifies so exactly the length of time for which, to his knowledge, Bertha required subsequent

treatment following the termination of Breuer’s treatment of her.

The story told to Zweig of the final scene of Anna O.’s treatment - the drama of the

hysterical pregnancy - is not present in the letter to Tansley; that drama is summed up in the

phrase “Breuer’s flight”. Yet the next sentence - ‘Subsequently the disease had run its course’ -

strikes a new note. It is as if the disease had an internal dynamic, relatively unaffected by

Breuer’s intervention. And Freud completes the sentence with a striking formulation: “it was a

cure with a defect (Heilung mit Defekt).” The rest of the letter is in one sense a clarification of

what this formulation means: healthy, capable of work, but, in order to be so, throughout the

whole of her life she was obliged to renounce sexual relations. This, we suggest, is the defect

Freud is referring to - rather than to the failure of Breuer’s treatment in curing her immediately.

What Freud is evoking is the psychoanalytic aim of rendering a patient capable of ‘love and

work’. Anna O., he is pointing out, was capable of work, but not love - in the sense of sexual

love.

However, a further sentence implies a different model of Anna’s treatment: “Breuer’s

treatment, so to speak, helped her over [hinweggeholfen] her mourning.” One might read this as
 12

attributing to Breuer’s cathartic cure the sole function of allowing her mourning to run its course

- independently of another episode of illness, one which was not connected with her mourning,

and one which was fundamentally unaffected by Breuer’s treatment. Speculatively, one might

say that Freud is implicitly invoking a complex, as opposed to simple, disease-picture, one laid

over the other. Breuer’s cathartic cure addressed only those symptoms connected with her

mourning for her father - but left untouched another disease, which progressed in accordance

with its own temporality.8 The syntactically peculiar feature of this sentence - why did Freud add

‘sozusagen’ (‘so to speak’)? - indicates hesitation about the correct verb to use to describe

exactly what Breuer’s treatment did to her mourning.

Given that the formula ‘cure with a defect’ is immediately followed by the brief sketch of

the striking sexual abstinence of Anna O.’s later life, the letter implies that the defect as much as

the cure should be attributed to, or at least put into connection with, Breuer’s treatment. What

could be the implication of the phrase Freud uses: “and, as Breuer said, which I remember well,

has not had any sexual relations”? Freud was almost certainly referring to the passage already

cited from Breuer’s case-history: “The element of sexuality was astonishingly undeveloped in

her. The patient, whose life became known to me to an extent which one person's life is seldom

known to another, had never been in love”. (Breuer and Freud (1895) 21-2) Here, in writing to

Tansley in 1932, he treats Breuer’s account as an accurate account of Anna O.’s sexual life - and

then extends it unchanged from the period of her treatment, when she was in her early 20s, to her

old age. The implication is that her sexuality as Breuer observed it got frozen in aspic - and that

Breuer’s treatment of her might have had a part in that process of freezing. It should also be

noted that, in his published account of the case in the Introductory Lectures of 1916-17, he had

made a similar, although less pointed, remark: “In spite of her recovery, in a certain respect she
 13

remained cut off from life; she remained healthy and efficient but avoided the normal course of a

woman’s life.” (Freud, S. (1916-17), 274)

It is the ordering of the sentences in the letter that is singular, and requires careful

interpretation. The last five sentences repeat an oscillation in time: from the moment of the cure

with a defect in the early 1880s to Anna O.’s fully unfolded and revealed life as seen in the

1930s, then back to the early 1880s and the exact effect of Breuer’s treatment, and then forward

again to the 1930s and her lifelong struggle against ‘white slavery’. Why does Freud engage in

this repeated oscillation?

While repeating the oscillation, the sentences have an opposite character to each other,

the first set negative, second set positive. The first set connects what was lacking in the cure - the

‘defect’ - with what was lacking in Anna O.’s later life - sexual relations. The second set

connects what Breuer’s treatment did do for his patient - helped over her mourning for the father

- with what she did do in her later, healthy life - campaign against ‘white slavery’. The

oscillation shows first the losses and then the gains of Anna O.’s life. Yet even the gain is

thematically related, Freud clearly implies, to her treatment by Breuer. Bertha Pappenheim

campaigned against the male exploitation and defilement of young women and also - and equally

- campaigned to safeguard young women from violation, setting up houses for their protection.

Freud implies that this positive action of protecting young women from being violated by men is

in some sense the positive version of the negative abstinence from sexual relations. It is what he

might elsewhere have called the substitute-formation, perhaps even the sublimation, of her

abstinence from sexual relations.

And, hidden in the subtext perhaps, but visible in this repeated oscillation and in the

subtle link between ‘Breuer’s flight’ and the ‘cure with a defect’, is the notion that Breuer failed
 14

to grasp Anna O.’s sexuality - it was his flight from her that left her with the permanent ‘defect’

of a sexless but healthy life. There is perhaps an assumption that underlies Freud’s account:

namely that there are moments in a person’s life, of which Anna O.’s ‘cure with a defect’ was

one, which constitute a crossroads, where irrevocable choices are made. Freud implies that

Breuer dropping Anna O. stone-dead slammed the door on one path out of her illness - via the

transference-love for Breuer to some other mode of liberation of her sexuality. As a result of her

being abandoned, she had to accomplish this work herself, in the mid-1880s, putting her self

back together as a self-made woman, and in the process closing down her sexuality forever - or

rather replacing it with her work on behalf of violated girls. All of Freud’s accounts make this

assumption: there are crossroads and turning-points in people’s lives, and this was one such for

Anna O.

Curiously enough, Breuer’s own unpublished notes, which Freud never saw, moved half-

way to recognizing something of the shift in her sexuality, a recognition one can be reasonably

certain Freud would have endorsed: “At all events, she has never been in love to the extent that

this has replaced her relationship to her father; it has itself, rather, been replaced by that

relationship.” (Breuer’s case notes, quoted in Hirschmüller (1978/1989) 108) Breuer mused that

Anna O.’s capacity for love was wrapped up in her relationship to her father. In 1914 Freud saw

the ‘untoward event’ as having revealed “the sexual motivation of this transference” that

Breuer’s treatment had benefitted from. It would be only a small step - Freud’s step - to see Anna

O.’s relationship to her father as having been transferred onto her therapeutic relationship to

Breuer. What Breuer’s flight did, Freud implied, was close up the Pandora’s box he had opened -

i.e. oblige Anna O. to undo the transference to Breuer and restore it once again to the hidden

place it had formerly occupied. Thenceforth her sexuality remained tied to her father and thus
 15

inertly invisible in an immediately recognizable sexual form. The defect of his treatment is to be

seen in Anna O.’s incapacity for sexual fulfilment.9 The text of this letter makes it more doubtful

that Freud’s view was that the cure of her illness (as opposed to the resolution of her mourning)

was to be attributed to that treatment.

It should be noted - and we hope that this reminder is superfluous - that these

speculations concerning Anna O.’s illness and Breuer’s treatment of her do not bear directly on

the actual facts of the matter, but solely on Freud’s construal and interpretation of them, as

indicated by this newly discovered letter.

It is, then, in the formulation ‘a cure with a defect’ that this letter adds to our knowledge

of Freud’s view of Breuer’s treatment of Anna O. Nonetheless, given the considerable debate

that has developed over Anna O., the famous first patient, there is much else in this letter which

will be of use to scholars.

THE QUESTION OF THE ADDRESSEE

It is worth remembering that every communication is framed and modulated by the specific

relationship between the two persons communicating. What might we be able to deduce from the

content of Freud’s letter about his relationship with Tansley? And, inversely, how might our

background knowledge of the relationship between Freud and Tansley guide our interpretation of

the letter?

The obvious comparison is with the letter Freud wrote to Stefan Zweig earlier in 1932, in

which he ‘divulged’ details of the ‘untoward event’ which terminated Anna O.’s treatment. None

of these details are to be found in Freud’s letter to Tansley. An immediate and evident, though
 16

not necessarily a sufficient, reason is that Freud was writing to Zweig to correct a version of the

Anna O. story that had appeared in print, which he, we may infer, wished Zweig to correct in

later editions of his book. Freud is already confronted with a public version of the Anna O. story

which he wishes to correct; having been minimally informative about the episode in his own

writing, he certainly did not wish to see an alternative - in his view, incorrect - version

circulating. In writing to Tansley, he is not confronted with such an extant public version; it is

most probable that Tansley’s letter was a simple letter of enquiry, and one which already took

into account Freud’s own published versions, and treated them as authoritative as far as they

went. Tansley simply wanted to know a little more. Freud told him a little more, but - with our

benefit of hindsight - was decidedly discreet about the details of the ‘untoward event’. Was this

only because Zweig had published an erroneous account, whereas Tansley was simply asking for

more information? Or was this because Zweig was close enough to Freud to be allowed these

details, whereas Tansley was not?

This question is a difficult one to answer. We know of others besides Zweig to whom

Freud revealed some of the details of the ‘untoward event’: Ernest Jones, James Strachey and

Marie Bonaparte. All four of these figures were undoubtedly closer to Freud than Tansley was,

and therefore there may have been a criterion of intimacy, if not reliability, that Freud informally

kept to in deciding to whom to reveal his ‘reconstruction’. It should be noted, however, that this

appears to have been exactly Tansley’s reason for writing to Freud, as he himself records it in his

lecture (full details are given below): “Freud indeed in a later work records his strong suspicion

that Breuer was eventually shocked to discover overt sexual manifestations in Anna, and that this

had something to do with his withdrawal from the cathartic work on hysteria. I had the curiosity

to write to Freud and enquire whether he knew exactly what happened.” The presence of such an
 17

‘intimacy-criterion’ may thus explain the fact that Tansley apparently did ask specifically about

the dénouement of the case of Anna O., and in effect was fobbed off, just as Ernest Jones was in

1928, with an interesting letter which did not reply adequately to Tansley’s question. In the letter

to Tansley, Freud gives the frame (absence of sexual relations, campaign against sexual

exploitation of girls - juxtaposed with “Breuer's flight”) without recounting the central scene.

Whatever Freud’s respect for Tansley - as a patient he knew and respected, and as a prestigious

man of science in Britain - he almost certainly did not regard him as an intimate. Nor was

Tansley completely sound on doctrinal questions - we know of at least one occasion when Freud

wrote a letter to a colleague of Tansley’s which criticised Tansley’s theoretical interpretations of

basic psychoanalytic concepts, such as the unconscious. (Cameron and Forrester, 1999) And

there is an additional factor: Tansley had already shown himself to be a capable and successful

popularizer of psychoanalysis, and quite possibly told Freud that his letter of enquiry was written

in the course of the preparation of public lectures on the early history of psychoanalysis. Freud

may, therefore, have been more careful than otherwise about what he told such an effective

popularizer, in the interests of ‘controlling’ the public view of psychoanalysis and its early

history.

PROVENANCE AND AUTHENTICITY

It is prima facie implausible that the letter in Tansley’s handwriting is anything other than a

letter from Freud. It does, after all, state at the top: “Letter from Freud on Breuer’s “Anna O.” 20

Nov. 1932.” What reason would Tansley, a respectable scientist and prominent supporter of

psychoanalysis, have for attributing to Freud a text which was not in fact by Freud? Nonetheless,
 18

to still all such doubts, we would like to present the circumstantial evidence which allows us to i.

endorse with circumstantial evidence the presumption based upon applying a principle of charity

to this manuscript; ii. place the letter more firmly within the context of Tansley’s own work, and

iii. give a reason as to why the only trace of the letter is this transcription of the original. This

evidence also allows us to conclude with certainty that Tansley was the original addressee of the

letter (i.e. he did not borrow this letter from a colleague - for instance, Ernest Jones, who, as we

have already noted, had in 1928 already asked Freud specific questions about Anna O.’s

treatment - and transcribe it for his own purposes).

The single page letter was found in an unlabelled box-file of Tansley’s papers in which

his executors stored many of his papers. There is nothing exceptional about this file, although

there is much that is interesting in it. There are typewritten drafts of papers, some by Tansley,

some by others; there are notes for lectures Tansley gave, both in botany and on “the new

psychology”. There are notes and drafts, including a Preface for a book called Essays on the New

Psychology, which Tansley appeared to be preparing for publication; however, this follow-up to

his first book on psychology never appeared. (Tansley did complete and publish a book entitled

Mind and Life, but of a very different sort, and only in the 1950s). There is also an

Autobiographical Introduction written by Tansley on the occasion of his delivering a talk to the

Magdalen College Philosophy Club (Oxford) in May 1932. One contextual fact of importance is

that there are many other notes in this box with the date 1932, most of them from earlier in the

year than November. There are also a series of notes on Freud's writings, particularly the

writings of the 1890s - on Angstneurosen, Abwehrneurosen, etc, - neatly dated and with page

references down the side, indicating a reference to the German texts Tansley was working on.
 19

There is also a manuscript of four or five pages of similar notes on some of the cases from

Studien über Hysterie - Katherina and Elizabeth von R. - but not Anna O. When it was first

found by L.C., the manuscript was not immediately adjacent to these notes, but was not

separated by many texts from them. Thus, the position of the letter in the box leads one to

believe that it formed part of Tansley’s research into Freud’s early writings in psychoanalysis.

This hypothesis is confirmed by a typewritten Ms. also in the box entitled ‘The Historical

Foundations of Psychoanalysis’. A detailed exposition of the case of Anna O, followed by a

discussion, constitutes pp. 5-19 of this Ms.; pp. 20-21 goes on to discuss the absence of sexuality

in the case, and the discussion continues on to p. 22. We quote from these pages:

In 1881 Breuer certainly had not the theoretical equipment necessary for anything like a

thorough analysis. He was simply feeling his way. It is clear for instance, in view of later

work, that the girl’s attachment to her father and the snake hallucination were strongly

sexual; and indeed Breuer’s report of the complete absence of any sexual manifestation in

her life or illness is in itself more than suspicious. Such a situation so far as we know

simply does not exist. Freud indeed in a later work records his strong suspicion that

Breuer was eventually shocked to discover overt sexual manifestations in Anna, and that

this had something to do with his withdrawal from the cathartic work on hysteria.

I had the curiosity to write to Freud and enquire whether he knew exactly what happened.

He replied that his suspicions were entirely confirmed by Breuer in reply to direct

questions from his own (Breuer’s) daughter whose interest was aroused by reading

Freud’s remarks: further, that in fact Anna became ill again when Breuer’s treatment

stopped and had to go to an institution for about 9 months. There she really did finally
 20

recover, and is now an old lady of over 70, having maintained her health; but she has

never married nor, so far as is known, has she ever had any love relation.

I think we may safely conclude that Breuer really did cure her of the very severe hysteria

precipitated by her father’s illness and death but that she then transferred her love to him.

After his “flight” as Freud calls it in his letter to me, she had a new attack, but with her

improved psychical and physical health she was able to overcome this after a time by

herself, very likely by renewed and now permanently effective repression, [JF: added in

pen by AGT: ‘but without the aid of “conversion” into physical symptoms’.] It is clear

that the situation in the traumatic scene when Anna was waiting for the surgeon by her

father’s sick bed was never analysed at all. The repression of the psychical elements

contributing to that psychical situation was never removed. However that may be, Breuer

deserves the greatest credit both for his persistence and for his insight into mechanism.”

This passage ends his discussion of the case of Anna O.; a bridge section then leads into an

exposition of the case of Lucy R., also from the Studien über Hysterie.

The faithfulness of this account to the letter from Freud printed above indicates that

Freud’s reply to his enquiry to which Tansley refers in his exposition is the one discovered in the

box. Thus, like Ernest Jones, Tansley’s curiosity concerning the exact fate of Anna O. had been

aroused both by the case-history itself and by Freud’s later discussions of it; almost certainly, it

was the following passage in On the History of the Psychoanalytic Movement that awakened

Tansley’s curiosity:

Anyone who reads the history of Breuer's case now in the light of the knowledge gained

in the last twenty years will at once perceive the symbolism in it - the snakes, the

stiffening, the paralysis of the arm - and, on taking into account the situation at the
 21

bedside of the young woman's sick father, will easily guess the real interpretation of her

symptoms; his opinion of the part played by sexuality in her mental life will therefore be

very different from that of her doctor. In his treatment of her case, Breuer was able to

make use of a very intense suggestive rapport with the patient, which may serve us as a

complete prototype of what we call `transference' to-day. Now I have strong reasons for

suspecting that after all her symptoms had been relieved Breuer must have discovered

from further indications the sexual motivation of this transference, but that the universal

nature of this unexpected phenomenon escaped him, with the result that, as though

confronted by an ‘untoward event’, he broke off all further investigation. He never said

this to me in so many words, but he told me enough at different times to justify this

reconstruction of what happened. When I later began more and more resolutely to put

forward the significance of sexuality in the aetiology of neuroses, he was the first to show

the reaction of distaste and repudiation which was later to become so familiar to me, but

which at that time I had not yet learnt to recognize as my inevitable fate. (Freud (1914)

11-12)

Further information about Tansley’s Ms. can be gleaned from a letter annexed to the Ms. from

John Rickman, dated 18 January 1933, which is without doubt a commentary on the typed Ms.,

since there are a number of marks in the margin which are John Rickman’s, clearly alluded to in

his letter to Tansley, which are then the starting point for Tansley’s emendations (in his own

hand) in scrupulous accordance with Rickman’s suggestions. Rickman’s letter allows Tansley’s

aim in the paper to become clearer. Rickman’s letter opens: “This paper is clear & convincing,

but what a difficult task you will have before you when you come to link it with the second

period characterised by the “Three Contributions”.” And he ends his letter on p. 5: “This paper is
 22

the easier of the two, the next will prove difficult; in this you have only to show how he de-

conditioned conditioned reflexes, in the next how the reflex paths are found - a very different

matter!/Yours ever/J.R.”

We can thus deduce that Tansley was writing a two-part paper which he intended - or

contemplated - submitting to the British Journal of Medical Psychology, for which Rickman was

Assistant Editor, in which capacity he was writing to Tansley; the paper would deal with the

development of Freud’s ideas in relation to biological science. (There is, indeed, an incomplete

Ms. in the box-file entitled “II Biology and Psychology”, but it is not clear that this was the

second part of the two-part paper, since it deals primarily with the general theory of instincts and

reflexes, in particular J.B. Watson’s ideas, in the context of evolutionary theory.) Nonetheless, it

is also clear that the Ms. in which Tansley used Freud’s information concerning Anna O. was

originally a spoken contribution to a Symposium (which internal evidence indicates took place in

the evening).

Furthermore, it is possible to infer that the passage concerning Freud’s letter to Tansley

was a late addition to the Ms. As we noted, the discussion of Anna O.’s sexuality covers pp. 20-

22 in the Ms.; the passage concerning Freud’s letter begins half way down p. 21 and finishes a

third of the way down the next page, which is numbered p. 21a (in typescript). The next four

pages were originally numbered 21, 22, 23, 24 in typescript, but have been altered in ink so as to

run 22, 23, 24, 25. From p. 26 on, the original numbering required no further emendation. In

addition, the pagination of p. 20 in the Ms. is in ink, not typescript, and the final sentence of the

page includes an addition in ink of ‘p. 22.’, implying that the text should go from this point to p.

22 - which is not the present p. 22, but is thus clearly a p. 22 of an earlier draft. Thus we can

infer that an original draft had interleaved in it the section discussing Anna O.’s subsequent fate,
 23

including the information derived from Freud’s letter. This makes it highly plausible that

Tansley had prepared the bulk of the lecture/paper before receiving Freud’s letter in late

November 1932, and then added this section (either for the version given to the Symposium or

subsequent to it, for the version sent to Rickman). Unfortunately, it has not been possible to

establish to which Symposium Tansley delivered this paper in late 1932.

Note also that this explanation of Tansley transcribing the letter explains the omissions

from the letter. Given what we know of Freud’s letter-writing habits, it is extremely unlikely that

he omitted to make any personal comments or ask for any of Tansley’s personal news; Tansley

was, after all, a former patient and respected follower of Freud’s. The omission of such passages

from the transcription is completely understandable if we recognize that Tansley was interested

for professional reasons only in the passage in the letter which was pertinent to his lecture/paper

on the development of psychoanalysis.

A final question can also be answered: Why did Tansley copy out Freud’s letter, since it

was addressed to him? One possibility is that he gave the letter to someone else, but, before

doing so, wished to retain a copy for himself. There is no evidence for this - though that does not

mean it is not true - although the above consideration (namely that this is clearly only the torso

of a letter) also argues against his having given the letter to someone else. There is, however,

evidence that Tansley had another reason for copying out the letter. In the summer of 1953, Dr

Kurt Eissler interviewed Tansley - probably in Cambridge; the interview was taped and later

transcribed. Dr. Eissler deposited the transcription in the Sigmund Freud Archives, which are

now held at the Library of Congress in Washington, D.C. Tansley gave Eissler an account of his

contact with Freud and, towards the end of the interview, the following interchange occurs:
 24

Eissler Have you preserved his letters?

Tansley Yes, I believe I’ve got them somewhere but I haven’t looked them up a long time.

But the correspondence is not /unclear/ on occasions /unclear/. But I wanted to

know about a new way of sedation of some what Freud had done. So I wrote and

asked him to tell me what happened in connection with it afterwards, and he

wrote me immediately, answering my question. I am bound to say I found

considerable difficulty because this German script /laughs/ wasn’t very good. I

mean the handwriting wasn’t very good. It puzzled me but I did eventually make

it out. /laughs/

Eissler Oh, you did?!

Tansley But that was all. You can’t say that we had a continuous correspondence of any

kind. But we did have a correspondence.

We suspect that the sentence “But I wanted to know about a new way of sedation of some what

Freud had done.” - on the face of it, a very odd thing to say - is a mangled transcription of a

statement referring to Tansley’s interest in the case of Anna O. (There are a number of other

similarly mangled transcriptions throughout the 22 page transcript.) It is plausible that ‘Patient’

might easily have been misheard by the transcriber as ‘Sedation’, particularly if transcription

mistakes in the words immediately prior to it had already been made. On this assumption, the

phrase “I wrote and asked him to tell me what happened in connection with it afterwards, and he
 25

wrote me immediately, answering my question” refers to Tansley’s initial enquiry about Anna O.

and Freud’s response in the letter published here for the first time. Tansley’s difficulty with

Freud’s gothic script has been shared by many others, particularly those not educated in the

schools of German-speaking countries. Thus we suspect that his puzzlement over Freud’s script

led him to copy out the letter in Roman script - reasonably successfully, we may infer, as the Ms.

here reproduced indicates (“I did eventually make it out”). Tansley’s difficulty in reading

Freud’s handwriting is thus sufficient explanation of his copying out the letter. Where the

original letter is, together with the other letters that Freud and Tansley exchanged, is not as yet

known.

Laura Cameron

Department of Geography

Downing Place

Cambridge CB2 3EN

John Forrester

Department of History and Philosophy of Science

Free School Lane

Cambridge CB2 3RH

 26

REFERENCES

Appignanesi, Lisa and Forrester, John (1992) Freud’s Women, London: Weidenfeld &

Nicolson/New York: Basic.

Borch-Jacobsen, Mikkel (1996), Remembering Anna O. A Century of Mystification, trans. Kirby

Olson, in collaboration with Xavier Callahan and the author, New York/London:

Routledge

Breuer, J and Freud, S. (1895), Studies on Hysteria SE II.

Cameron, Laura, and Forrester, John, ‘“A nice type of the English scientist”: Tansley, Freud and

a Psychoanalytic Dream’, History Workshop Journal, forthcoming, Autumn 1999

Ellenberger, Henri F. (1972) `The story of “Anna O.”: A critical review with new data' Journal

of the History of the Behavioral Sciences 8 267-79

Fichtner, Gerhard (1989) ‘Les lettres de Freud en tant que source historique’ Rev. Int. Hist.

Psychoanal. 2 51-80

Forrester, John (1986)`The true story of Anna O.' Social Research 53 327-347; also in Forrester

(1990)

Forrester, John (1990) The Seductions of Psychoanalysis. Freud, Lacan and Derrida.

Cambridge: Cambridge University Press, 17-29

Freud, S. (1910) Five Lectures on Psycho-Analysis, SE XI

Freud, S (1914), On the History of the Psycho-Analytic Movement, SE XIV.

Freud, S. (1915) ‘Observations on transference-love’ SE XII

Freud, S. (1916-17) Introductory Lectures on Psycho-Analysis (1916-17) SE XVI

 27

Freud, S. (1923 [1922]) ‘Two encyclopaedia articles’ SE XVIII

Freud, S (1924 [1923]) ‘A short account of psycho-analysis’ SE XIX

Freud, S. (1926) ‘Psycho-analysis’ SE XX

Freud, S. (1960) Letters, ed. Ernst L. Freud, trans. Tanya and James Stern, London, Hogarth.

Freud/Jones (1993). The Complete Correspondence of Sigmund Freud and Ernest Jones 1908-

1939, edited by R. Andrew Paskauskas, introduction by Riccardo Steiner, Cambridge,

MA/London, Harvard U.P.

Hirschmüller, Albrecht (1978/1989) Physiologie und Psychoanalyse in Leben und Werk Josef

Breuers, [Jahrbuch der Psychoanalyse, Suppl. 4], Bern: Hans Huber, 1978, trans. The life

and work of Josef Breuer. Physiology and psychoanalysis, New York/London: New York

University Press, 1989

Rosenbaum, Max and Melvin Muroff (eds.) (1984), Anna O: Fourteen contemporary

reinterpretations, New York & London: Free Press

 28

1
We would like to thank Professor Leigh of the Department of Plant Sciences for

permission to quote from the letter and other documents, and the Department's Librarian Dr.

David Briggs and the Assistant Librarian, Mr. Richard Savage, for their help in working with the

manuscripts. We would also like to thank Dr. Kurt Eissler for permission to see the transcript of

his interview with Tansley and the other papers Tansley sent him which are on Restricted Access

at the Library of Congress; we would also like to thank the Library of Congress for their help in

this research.
2
While there has developed considerable historiographical controversy concerning the fate

of Anna O. and her place in the development of psychoanalysis, this is not the place to review all

the nuances of this debate. (For information concerning these debates, see Rosenbaum and

Muroff (1984) and Borch-Jacobsen (1996).) The full reasons for attributing the letter to Freud

are given in the final section of this paper. Further evidence, involving a more detailed account

of Tansley’s life and work within the field of psychoanalysis can be found in our paper on ‘“A

nice type of the English scientist”: Tansley, Freud and a Psychoanalytic Dream’ (Cameron and

Forrester (1999)), based upon the study of his papers as deposited in Cambridge, in Washington,

D.C., and elsewhere.

3
We would like to thank Prof. Dr. Gerhard Fichtner for his help in the reading of the

transcription of this letter, and for pointing out errors of transcription that Tansley almost

certainly made in his own transcription, and also Andreas Mayer for advice on the translation.

For the record, the above transcription departs from the hand-written Ms. in the following points:

Second para, third sentence: there is no comma after ‘die Tatsache’

Second para, fifth sentence: there is no comma after ‘Sie hat’

 29

Second para, sixth sentence: in the original Ms., ‘sozusagen’ is written ‘so zu sagen’

Second para, sixth sentence: in the original Ms., ‘hinweggeholfen’ is written ‘hin weggeholfen’

Second para, final sentence: in the original Ms., there is no comma after ‘Es ist interessant’

Fichtner notes that in transcribing Freud’s handwriting, it is easy to overlook the commas.
4
By JF.
5
Breuer and Freud (1895) 41: “After this she left Vienna and travelled for a while; but it

was a considerable time before she regained her mental balance entirely. Since then she has

enjoyed complete health.”

6
Thus the first sentence of the letter confirms Gerhard Fichtner’s reasoning (1989, 74-75).

It also coincides with the account given by Marie Bonaparte in her Notebooks, reproduced in

Borch-Jacobsen (1996, 100), but contradicts the version of Bonaparte’s notes transcribed by

Swales and endorsed by Borch-Jacobsen in his reasoned footnote (1996, 36 n 14), which

interpreted Freud as implying that Dora Breuer’s questioning of her father took place in 1914 or

shortly thereafter.
7
In contrast with other documents, whose tone is oppositional, such as the account,

according to Swales’ transcription, that Marie Bonaparte gave of what Freud told her about his

‘break’ with Breuer over the misleading nature of Breuer’s case history of Anna O. in its final

published version of 1895; see Borch-Jacobsen (1996, 98): “Freud said that the real reason he

broke with Breuer was over his misrepresentation of what really had happened in publishing the

case of Anna O. in 1895. Freud quoted the line about Anna’s mental equilibrium... and declared

that Anna O. was not in fact cured but remained ill for some time after.” The fact that Freud is

said by Bonaparte to have cited this particular passage from the Studies and does so (again) in

his letter to Tansley is a strikingly convincing detail - convincing of two things: 1. that Swales’
 30

memory was in this instance reliable; 2. that the other element of Bonaparte’s story - the break

over Anna O. - is rendered more convincing. Nonetheless, without further textual evidence, one

should treat this account with circumspection. It should also be noted that Strachey reported

Freud as having pointed to exactly the same passage in a conversation with him (unfortunately

not possible to date - and it could not have been when Strachey translated Studies on Hysteria,

since he and Alix Strachey translated it for the first time in 1955): “At this point (so Freud once

told the present editor, with his finger on an open copy of the book) there is a hiatus in the text.

What he had in mind and went on to describe was the occurrence which marked the end of Anna

O.’s treatment.... it is enough to say here that, when the treatment had apparently reached a

successful end, the patient suddenly made manifest to Breuer the presence of a strong unanalysed

positive transference of an unmistakably sexual nature.” (Breuer and Freud (1895) 40-1n1)
8
Note that this view of Anna O. as suffering from two different conditions is in conformity

with a persistent feature of Freud’s published expositions of her illness: his emphasis on the

relation between Breuer’s cathartic work with Anna on her memories and the removal of the

symptoms. Nearly all of Freud’s account emphasize symptoms, not a disease, and he highlights

the removal of specific symptoms, and rarely talks of her overall cure. Typical of this judicious

passing over in silence of the prolonged illness of Anna O. is the following exposition, which

ends his account of her treatment, from the Five Lectures: ““When the patient had recollected

this scene [of the hallucination of a snake at her father's bedside] in hypnosis, the rigid paralysis

of her left arm, which had persisted since the beginning of her illness, disappeared, and the

treatment was brought to an end.” (Freud (1910) 15) Even one of the most enthusiastic accounts

of Breuer’s success, written in 1923, appends a caution about the enduring character of the

efficacy: ““By consistently repeating the same laborious process, he succeeded in freeing her
 31

from all her inhibitions and paralyses, so that in the end he found his trouble rewarded by a great

therapeutic success as well as by an unexpected insight into the nature of the puzzling neurosis....

It soon appeared that the therapeutic hopes which had been placed upon cathartic treatment in

hypnosis were to some extent unfulfilled. It was true that the disappearance of the symptoms

went hand-in-hand with the catharsis, but total success turned out to be entirely dependent upon

the patient's relation to the physician and thus resembled the effect of ‘suggestion’. If that

relation was disturbed, all the symptoms reappeared, just as though they had never been cleared

up.” (Freud (1923 [1922]) 235-7)

9
One might cite one of Freud’s strongest and clearest statements of this ‘obvious’ criterion

of success: “Sexual love is undoubtedly one of the chief things in life, and the union of mental

and bodily satisfaction in the enjoyment of love is one of its culminating peaks. Apart from a few

queer fanatics, all the world knows this and conducts its life accordingly; science alone is too

delicate to admit it.” (Freud (1915) 169-70)